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NBME Free 120 Questions and answers | With complete solution Latest 2024/25
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NBME Free 120 Questions and answers | With complete solution Latest 2024/25
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NBME Free 120 Questions and answers |With complete solution Latest 2024/25
A 28-year-old man comes to the physician because of a 1-year history of pain with
urination that has increased in severity
during the past month. He also has had episodes of blood in his urine during the past 5
years. He lived in sub-Saharan Africa
until he came to the USA 6 months ago for graduate school. His temperature is 38°C
(100.4°F), pulse is 80/min, respirations
are 16/min, and blood pressure is 110/84 mm Hg. Physical examination shows
suprapubic tenderness. Imaging studies show bilateral hydroureter and hydronephrosis
and foci of calcification in the region of the bladder. A biopsy specimen of the bladder
shows marked chronic inflammation with fibrosis and scattered granulomas. Which of
the following
best explains the biopsy findings? - Schistosomiasis
A 14-year-old boy is brought to the emergency department after being hit with a
baseball bat on the lateral side of his leg
immediately below the knee. He is unable to dorsiflex his foot. Which of the following
nerves is most likely injured? - Common fibular (peroneal)
A 24-year-old man comes to the office because of a 2-day history of a red, itchy rash
on his buttocks and legs. Four days ago,
he returned from a cruise to the Caribbean, during which he swam in the ship's pool and
used the hot tub. He appears well.
His vital signs are within normal limits. Physical examination shows the findings in the
photograph. The infectious agent
causing these findings most likely began to proliferate in which of the following
locations? - Hot tub folliculitis
Invades the hair follicle
A 14-year-old girl is brought to the physician after her mother learned that she began
having sexual intercourse with various
partners 1 month ago. She does not use condoms or other contraception. The mother is
concerned about her behavior. The
patient's parents separated 3 months ago. She had been an honor student and excelled
in sports and leadership positions at
school before the separation. Since the separation, however, she has become sullen,
defiant, and rebellious. She has begun
smoking cigarettes, disobeying her curfew, and being truant from school. This patient is
most likely using which of the following defense mechanisms? - Acting out
, A 24-year-old woman comes to the physician for a follow-up examination. One week
ago, she was treated in the emergency
department after she accidentally spilled hot grease on her left leg while working at a
fast-food restaurant. Examination of the
left lower extremity shows a 7-cm, pink, soft, granular, edematous wound. The
formation of this tissue was most likely
caused by increased activity of which of the following? - Granulation tissue--> VEGF and
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FGF
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A 63-year-old woman comes to the physician 1 day after the sudden onset of pain and
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swelling of her right knee. She has had
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no injury. Her medications include occasional ibuprofen for mild osteoarthritis of both
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knees. Her temperature is 37°C (98.6°F), pulse is 97/min, respirations are 19/min, and
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blood pressure is 129/79 mm Hg. Examination of the right knee shows warmth, erythema,
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and effusion. Exquisite tenderness is produced with minimal range-of-motion testing.
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Examination
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of synovial fluid obtained via joint aspiration shows that it is clear, with positively
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birefringent rhomboids observed under
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polarized light microscopy. Deposition of which of the following substances is the most
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likely cause of these findings? - Pseudogout--> calcium pyrophosphate crystals
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A 55-year-old woman with small cell carcinoma of the lung is admitted to the hospital to
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undergo chemotherapy. Six days
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after treatment is started, she develops a temperature of 38°C (100.4°F). Physical
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examination shows no other abnormalities.
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Laboratory studies show a leukocyte count of 100/mm3 (5% segmented neutrophils and ii ii ii ii ii ii ii ii ii ii ii
95% lymphocytes). Which of the
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following is the most appropriate pharmacotherapy to increase this patient's leukocyte
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count? - Filgrastim
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A 37-year-old woman with right lower extremity edema is evaluated because of the
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sudden onset of shortness of breath and
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pleuritic chest pain. A diagnosis of pulmonary embolism is made. Which of the following
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signs, if present on physical
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examination, would be the most specific indicator of pulmonary arterial hypertension in this ii ii ii ii ii ii ii ii ii ii ii ii
patient? - P2 louder than A2
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During an experiment, a Southern blot analysis is done by digesting DNA samples with a
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single restriction endonuclease,
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separating the digestion products by gel electrophoresis, and transferring them to a filter. ii ii ii ii ii ii ii ii ii ii ii ii
The investigator probes the filter by
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exposing it to a cDNA clone that encodes a single immunoglobulin-constant region. The
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figure shows the resulting pattern
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with DNA samples isolated from different organs. Assuming there were no technical errors,
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the Southern blot analysis results
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demonstrate which of the following processes? - Gene rearrangement ii ii ii ii ii ii ii ii ii ii
, . During a clinical study examining the effects of exercise, men between the ages of 20 and
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30 years are evaluated during a 15-
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minute session on a treadmill. The average pulse for the last 2 minutes of the session is
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175/min. During the last minute of
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exercise, various measurements are taken. Compared with the measurement before the ii ii ii ii ii ii ii ii ii ii
session, which of the following is
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most likely to be decreased? - Total peripheral resistance
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A 26-year-old man is brought to the emergency department by ambulance 30 minutes
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after being shot in the leg. He is
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unconscious and appears markedly pale. His pulse is 120/min, respirations are 16/min, ii ii ii ii ii ii ii ii ii ii ii
and blood pressure is 80/60 mm Hg.
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Compared with a healthy adult, which of the following findings is most likely in this patient? ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
- Arterial BR firing rate: decreased
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SVR: increased ii
PVR: increased ii
Systemic capillary fluid transfer: absorption ii ii ii ii
A 17-year-old boy is brought to the emergency department 30 minutes after being found
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with a "blank stare" and flat facial
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expression at a party. His pulse is 72/min, and blood pressure is 104/68 mm Hg. He is ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
sitting upright and appears catatonic.
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Physical examination shows rigidity. During the examination, he becomes hostile and
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attempts to assault the physician. This
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patient most likely ingested which of the following drugs? - PCP
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A 26-year-old woman is brought to the emergency department because of an 8-hour
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history of severe back and abdominal
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pain and mild but persistent vaginal bleeding. Ultrasonography of the abdomen shows a 2-
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cm ectopic pregnancy in the
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ampulla. The ampulla has ruptured into the surrounding tissue. Fluid from this rupture will
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most likely be found in which of
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the following locations? - Pouch of Douglas
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A 14-year-old girl has had nausea, intermittent diarrhea, and a 2.2-kg (5-lb) weight loss
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over the past 4 weeks. Examination shows a migrating serpiginous pruritic perianal rash.
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Her leukocyte count is 8000/mm3 with 20% eosinophils. Which of the following tests is
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most likely to yield an accurate diagnosis? - Microscopic examination of the stool
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A 40-year-old woman comes to the physician because of a 6-month history of increased
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facial hair growth. Her last menstrual period was 4 months ago. She is 165 cm (5 ft 5 in) tall
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and weighs 70 kg (154 lb); BMI is 26 kg/m2. Her pulse is 80/min, and blood pressure is
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130/82 mm Hg. Physical examination shows temporal balding and coarse dark hair on the
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upper lip and chin. Pelvic examination shows clitoral enlargement. Her serum testosterone
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